Isifinyezo Sezici Zezifo Ezihlukahlukene Zomgogodla

I-Spinal discitis yenza u-2% kuya ku-7% wazo zonke izifo ze-musculoskeletal ezibangelwa amagciwane, isikhunta, futhi, okungavamile, yizinambuzane. Cishe isigamu sazo zonke izimo zezifo zomgogodla zitholakala ku-lumbar spine, kancane ngaphezu kwengxenye eyodwa kwezintathu emgodleni we-thoracic, kanti okusele kumgogodla wesibeletho.

Ukutheleleka kwe-Purulent

I-Purulent spinal discitis (PS) ngokuvamile ibangelwa ukutheleleka okusatshalaliswa nge-hematogenously, kanti i-Staphylococcus aureus iyigciwane elivame kakhulu, elivame ukubandakanya umgogodla we-lumbar, kanye nama-x-ray angenakho ukucaciswa nokuzwela ezigabeni zokuqala zesifo. I-MRI ethuthukisiwe iyindlela yokuzikhethela yokuxilongwa kokuqala kwezifo zomgogodla; I-MRI ibonisa i-edema yomnkantsha wamathambo kanye nokuthuthukiswa kwemizimba ye-vertebral, ama-intervertebral discs, isikhala se-epidural, kanye / noma izicubu ezizungezile ezithambile ezinokwakheka noma ngaphandle kwethumba elitholakala ngokuyinhloko eduze kwama-endplates e-vertebral.

Qaphela: (a) I-Lateral lumbar spine radiograph ebonisa i-L4 -L3 ukulahleka kobude bediski kanye nokubhujiswa kwe-endplate engenhla ye-L4 (umcibisholo). 

(b) Isiliphu sangemuva esithambile ku-L3. ukubhujiswa kwe-L3 - L4 disc enezinguquko ezigugulekayo kuma-endplates aseduze (imicibisholo). 

(c) Isithombe se-Magnetic resonance (MR) esibonisa izinguquko ezigugulekayo ze-vertebral endplates kanye nesignali engavamile yomnkantsha wethambo lomgogodla oseduze (umcibisholo). Izicubu ezithambile ze-prevertebral zine-edema ephawulekayo futhi zinezinguquko ezivuthayo. 

(d) I-Sagittal t1 ngemva komjovo wokungafani we-intravenous ibonisa isignali ethuthukisiwe emnkantsheni wethambo (inkanyezi), isignali ethuthukisiwe endaweni ye-epidural kanye nezicubu ezithambile ze-prevertebral. Qaphela ukuhlehla komsele omaphakathi (umcibisholo).

Isifo Sofuba Somgogodla

Isifo sofuba somgogodla (TS), ukutheleleka komgogodla okungeyona i-purulent granulomatous okubangelwa i-Gram-positive Mycobacterium tuberculosis, kanye nezici zokuthwebula ezihlukanisa i-TS ku-PS zikhonjiswe etafuleni elingezansi:

Ama-radiographs aphuzile abonisa ukubhujiswa kwamathambo, ukuncipha kobude bediski kanye namathumba ezicubu ezithambile ngokubala noma ngaphandle kokubala kwezicubu ezithambile ezizungezile.

Ku-MRI, i-t1 ejwayelekile ye-low-signal intensity kanye ne-high-signal intensity yokulandelana kwe-fluid-sensitive kuhilela umzimba we-vertebral wangaphambili futhi ingadlulela ngendlela engaphansi kwe-subligamentous eya kwamanye ama-vertebrae, ngokuvamile ngaphandle kokubandakanya i-disc.

Amanothi: Owesilisa oneminyaka engu-65 oneminyaka engu-(a) ne-axial kanye (b) namathumba e-lumbar (i-asterisk) ene-septal kanye nokuthuthukiswa kodonga (imicibisholo emhlophe) .L3 kuya ku-S1 ukuthuthukiswa komzimba we-vertebral. I-intervertebral disc egoqiwe ngaphandle kokuthuthukiswa okubalulekile. Ukucindezelwa kwesaka eliphakathi (umcibisholo omhlophe). (c) ct isithombe sokwakhiwa kabusha kwe-L3 kuya ku-S1 ukubhujiswa komzimba we-vertebral.

I-Brucella Infection

I-Brucellosis iyisifo esivamile emhlabeni wonke esibangelwa i-bacillus e-gram-negative. Ngokuvamile kuhilela i-lumbar spine, ikakhulukazi i-L4.

Lesi sifo siqala engxenyeni yangaphambili yomzimba we-vertebral we-disc intervertebral futhi singalimaza amalunga amancane. Amathumba e-Paravertebral ayenzeka kancane futhi mancane ngosayizi kune-TS. I-vertebral anatomy ihlala injalo.

Qaphela: Ukutheleleka kwe-Brucella lumborum, ama-radiographs abonisa i-sclerosis ye-lumbar vertebrae, ukushelela phambili kwe-lumbar vertebrae, ukubhujiswa okungavamile okufana nesinyathelo emkhawulweni wangaphambili womzimba we-vertebral, nokwakheka kwama-cribriforms amathambo emkhawulweni wangaphambili womzimba we-vertebral.

Ukutheleleka kwefungal

Izifo zomgogodla wesikhunta (FS) azivamile futhi zivame ukubonakala ezigulini ezingenawo amandla omzimba. Isikhunta esiningi singase sibandakanyeke, okuhlanganisa i-Pseudomonas, i-Aspergillus, i-Bacillus, ne-Coccidioides. Umgogodla we-thoracic uyindawo evamile kakhulu, futhi efana ne-TS, inqubo yokutheleleka iqala engxenyeni yangaphambili ye-vertebrae futhi ngezinye izikhathi ingasakazeka kuma-vertebrae angasondelene.

Qaphela: Isithombe se-CT scan sagittal sesiguli esine-coccidioidomycosis. Izilonda ezilinganiselwe zamathambo ezingenawo amamajini e-sclerotic zivamile zale pathogen esethulweni. ukubhujiswa okukhulu kwe-T1 kuholela ekuweni kwe-vertebral. Naphezu kokulimala okukhulu kwe-bony, indawo ye-C7-T1 ye-intervertebral yagcinwa, ukuguqulwa kwesici ku-coccidioidomycosis (iphaneli yesokudla) i-Sagittal MRT2WI yesiguli esifanayo iqinisekisa ukulondolozwa kwenyanga ye-C7-T1 ye-intervertebral space, ngesignali ephawulekayo ye-T2 ephakamisa ukubandakanyeka kokuqala kwama-disc C6-C7. I-bony lesion inwebelwa ethanjeni elingaphansi kwe-subcortical ukuya emzimbeni we-vertebral, okuholela ekutheleleni kwezicubu ezithambile zangaphambili IV. Izinguquko ezithathelwanayo zisakazekela kumazinga amaningi, zikhomba kalula indlela yokusabalalisa uhlobo lwe-subligamentous, olungaholela ezilonda eziningi emazingeni angasondelene.

I-Ankylosing Spondylitis

I-Ankylosing spondylitis (AS) isifo esingelapheki sokuvuvukala kwe-autoimmune esithinta ngokuyinhloko umgogodla futhi singaholela ebuhlungwini obunzima obungapheli obuvela ekuhlanganiseni komgogodla.

Enye inkinga ezigulini ezine-AS ukuthuthukiswa kwesifo se-disc esilinganiselwe, futhi ekucabangeni, i-AL ingahlukaniswa ne-spondylitis evuthayo ngokukhubazeka okugxile ku-vertebrae eyodwa noma amabili aseduze, ukunciphisa isikhala se-disc, nezindawo ze-sclerosis esebenzayo ezungeze ukukhubazeka kwe-osteolytic.

Qaphela: Isiguli esine-spondylitis e-ankylosing, owesilisa oneminyaka engu-44 ubudala onobuhlungu obungapheli obuphansi emuva kanye nohlu olulinganiselwe lokunyakaza. I-Sagittal ct ye-(a) thoracic kanye (b) namafasitela ethambo lomgogodla we-lumbar abonisa i-diffus ligamentous syndesmosis emgudwini we-longitudinal wangaphambili (imicibisholo). Kukhona ne-ossification kanye nokuhlanganiswa kwemigqa ye-lumbar interspinous (imicibisholo ekhonjisiwe). (c) Isithombe se-Coronal ezingeni le-lumbar spine sibonisa ukuhlangana kwezinto ezingemuva kanye nama-articular synovial joints (imicibisholo).

I-Osteomyelitis Syndrome

Igama elithi SAPHO libhekisela ekuhlanganiseni kokubonakaliswa kwemisipha nokuqina kwesikhumba (i-synovitis, induna, i-pustulosis, i-osteomalacia, ne-osteomyelitis), enodonga lwangaphambili lwesifuba (kuhlanganise namajoyinti e-sternoclavicular, amalunga e-costothoracic, kanye nendololwane ye-sternoacetabular i-lumbar evame ukuthinteka) Umgogodla.Ukubonakaliswa okuvame kakhulu kuma-x-ray radiographs i-vertebral body osteolysis ngokuwa noma ngaphandle kokuwa, kanye ne-osteomalacia kanye ne-ossification ye-paraspinal.I-MRI iyisithombe se-imaging esibucayi kakhulu i-MRI yindlela yokucabanga ebucayi kakhulu, futhi ukubonakaliswa kwayo okuyinhloko kuhlanganisa izinguquko zesignali ye-vertebral esabalele noma egxile ekulandeleni kwe-fluid-sensitive kuma-intervertebral e-intervertebral e-intervertebral. ama-intervertebral discs noma ama-endplates angaphambili, kanye ne-soft tissue edema.

Qaphela: Owesilisa oneminyaka engama-62 ubudala one-SAPHO syndrome. (a) Izithombe ze-Sagittal t2-weighted kanye (b) ne-computed tomography (CT) zibonisa i-ossification ye-anterior longitudinal ligament (imicibisholo emnyama) Akukho okungavamile okuphawulekayo kwe-disc noma i-paravertebral fluid. I-L1 ibekwe kabusha kakhulu ngemva kokuphuka okudala kokucindezelwa. (c) I-Axial CT ibonisa i-ankylosis ye-costovertebral joint efanele (asterisk). (d) Ukwakhiwa kabusha kwe-CT ye-Oblique coronal kubonisa i-bilateral thoracic ribcage clavicle ankylosis (izinkanyezi ezimnyama). (e) Ukuskena kwethambo okubonisa ukutholwa kwe-radiotracer kuwo womabili amalunga athintekile (izinkanyezi ezimhlophe).

I-Spondyloarthropathy ehlobene ne-Dialysis

I-Dialysis-related spondyloarthropathy (DRS) iwushintsho lwe-pathologic ezigulini ezithatha i-hemodialysis yesikhathi eside. Kuvame kakhulu emgodleni womlomo wesibeletho futhi ngokuvamile kubonisa ukuncipha kwesikhala se-intervertebral, ukubhujiswa kwama-endplates, ukungabi khona kwe-sclerosis, ukwakheka kwamathambo amasha, izifo ze-paraspinal / amathumba, nokuqinisa isikhala.

Qaphela: I-osteoporosis ebanzi ye-lumbar ne-sacral pelvis. Ukucekelwa phansi kwe-anterosuperior margin ye-lumbar 5 vertebrae ene-sclerotic hyperplasia ye-margins (ekhonjiswe umcibisholo obomvu). I-hyperplasia yezibazi eziseduze. Ukucekelwa phansi kwelunga lesacroiliac elingakwesokunxele ngokucekelwa phansi kwendawo engemuva ye-ilium, amathambo amaningi angaphakathi afile, kanye ne-hyperplasia yethishu efana nesibazi (eboniswa imicibisholo eluhlaza okwesibhakabhaka).

Qaphela: I-MR ethuthukisiwe: I-Lumbar 4/5 i-disc bulge ene-vertebral rim osteophytes, i-hypertrophy ye-ligamentum flavum, ukuncishiswa kancane komgogodla womgogodla, nokucindezelwa konqenqema lwangaphambili lwe-sac dural. Umzimba we-lumbar 5 we-vertebral unomkhawulo omncane futhi ungabonakala njengemigqa ye-T1 ne-T2 WI yokucindezela amafutha aphezulu isignali ephezulu, futhi ukuthuthukiswa kubonakala ngemva kokuthuthukiswa. Iziqephu eziningi zesignali engavamile zibonakala ngaphansi kwama-endplates e-lumbar 5 ne-sacral 1 nangaphansi kwamalunga e-sacroiliac, anesignali ephansi ku-T1WI kanye nesignali ephakeme kancane ku-T2WI, futhi ukuthuthukiswa kubonakala ekuhloleni okuthuthukisiwe (imicibisholo ebomvu). Ukuqina kwezicubu ezithambile emaphethelweni angaphambili omgogodla we-sacral kwabonakala, futhi ukuthuthukiswa kubonakale ekuskeneni okuthuthukisiwe (umcibisholo oluhlaza okwesibhakabhaka). Izibonakaliso zethambo ze-ilium, i-hip, i-sacrum kanye nekhanda lesifazane ezinhlangothini zombili ze-pelvis azizange zibonise noma yikuphi ukungavamile okusobala, futhi izimpawu zemisipha yangaphakathi nangaphandle ye-pelvic zazivamile, zinezikhala ezicacile zemisipha kanye nezikhala ezivamile ezihlangene, ngaphandle kwezibonakaliso zokwandisa nokunciphisa.

I-Spinal Gout

I-gout yomgogodla ibonakala ngokufakwa kwe-monocrystalline urate crystals (MUCs) emgogodleni. I-gout yomgogodla ithinta kakhulu umgogodla we-lumbar. ama-radiographs abonisa ukubonakaliswa okungaqondile futhi i-CT ibonakalisa kangcono ukuguguleka kwamathambo nge-sclerotic margins. ukubonakaliswa kwe-mri akucacisiwe.

Qaphela: I-CT plain scan ibonisa ukuncipha kwesikhala esihlanganyelwe kanye nokucekelwa phansi kwe-articular surface yamazwe amabili. I-Arthrocentesis iyadingeka ukuze kuqinisekiswe ukuxilongwa.

I-Neurospondylitis

I-Neurogenic spondylitis (NS), i-arthropathy eqhubekayo elimazayo, yenzeka ngemva kokulahlekelwa ukuzwa nokuqonda. Isizathu esivame kakhulu ukulimala komgogodla okubuhlungu, okubalelwa ku-70% wamacala. Ezinye izimbangela zihlanganisa isifo sikashukela, isifo se-spinal cord cavernous, nezinye izifo ze-neurologic ezifana ne-peroneal muscular dystrophy kanye ne-Guillain-Barré syndrome. Ngenxa yendima ye-thoracolumbar kanye ne-lumbosacral junctions ekuthwaleni isisindo, yizindawo ezivame ukubandakanyeka kakhulu.

Ukubonakaliswa okujwayelekile kwe-NS yizicucu zamathambo, ukungahambi kahle kwamalunga e-intervertebral kanye nokungahambisani okuholela ekusheleleni komzimba we-vertebral, ama-endplates amaningi kanye nokuguguleka kwamalunga amancane kanye nokugcinwa kokuqina kwamathambo ku-sclerosis, kanye nezixuku zezicubu ezithambile.

Qaphela: Owesilisa oneminyaka engu-58 ubudala onomgogodla we-neuropathic. (a) I-Sagittal kanye (b) ne-coronal computed tomographic reconstructions ibonisa ama-endplates amaningi e-lumbar vertebral kanye nama-articular synovial joint erosions (imicibisholo) enezicucu zamathambo. Ukubhujiswa kweyunithi ye-L2-L3 intervertebral disc ngokunwetshwa kwesikhala se-intervertebral (asterisk). (c) I-Sagittal kanye (d) ne-axial t2-weighted magnetic resonance sequences eqinisekisa ukunwetshwa kwesikhala se-L2-L3 intervertebral. izinguquko eziphawulekayo zomgogodla othintekile ngemuva kwe-L2-L3-L4. Kukhona futhi ukukhishwa kwezicubu ezithambile ngemuva nangaphambili kwezinqubo ze-spinous (asterisks).